Gemcitabine, Dexamethasone, and Cisplatin Regimen as an Effective Salvage Therapy for High-grade B-cell Lymphoma with MYC and BCL2 and/or BCL6 Rearrangements

Intern Med. 2019 Feb 15;58(4):575-580. doi: 10.2169/internalmedicine.1686-18. Epub 2018 Sep 12.

Abstract

A 61-year-old woman exhibited right inguinal lymphadenopathy and right lower limb edema approximately 1 month prior to hospitalization. She was diagnosed with high grade B-cell lymphoma, and a lymph node biopsy and fluorescence in situ hybridization indicated MYC, BCL2, and BCL6 rearrangements (triple-hit lymphoma). She had progressive disease that was CD20-negative after two courses of rituximab, cyclophosphamide, doxorubicin, vincristine, methotrexate/ifosfamide, etoposide, high-dose cytarabine (R-CODOX-M/IVAC) therapy. Subsequent etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin (EPOCH) therapy was not effective. However, after two cycles of gemcitabine, dexamethasone, and cisplatin (GDP) therapy, she achieved a complete response and was able to undergo autologous peripheral blood stem cell transplantation. GDP therapy may be effective as salvage therapy for chemotherapy-resistant triple-hit lymphoma.

Keywords: GDP; high-grade B-cell lymphoma (HGBL) with MYC and BCL2 and/or BCL6 rearrangements; triple-hit lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Cisplatin / therapeutic use*
  • DNA-Binding Proteins / genetics*
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Dexamethasone / therapeutic use*
  • Female
  • Gemcitabine
  • Gene Rearrangement
  • Humans
  • Lymphoma, B-Cell / drug therapy*
  • Lymphoma, B-Cell / genetics*
  • Lymphoma, B-Cell / pathology
  • Middle Aged
  • Salvage Therapy
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • DNA-Binding Proteins
  • Deoxycytidine
  • Dexamethasone
  • Cisplatin
  • Gemcitabine